Effects Of Leucocyte-and Platelet-rich Plasma On The Osteogenic Differentiation Of Bone Marrow Stromal Cells In Treating Femoral Head Necrosis In Rabbits

Objective Various head-preserving procedures has been used to treat avascular necrosis of femoral head(ANFH). However, all the treatments are not satisfied. Leucocyte- and platelet-rich plasma(L-PRP), which contain a lot of growth factors, associated with bone marrow mesenchymal stem cells(BMSCs) could get satified results of treating some orthopedics diseases. But the application of L-PRP on ANFH. This research aims to evaluate the efficacy of leucocyte- and platelet-rich plasma(L-PRP) on the osteogenic differentiation of bone marrow stromal cells(BMSCs) in treating avascular necrosis of femoral head(ANFH)in rabbits.Methods Twenty-four New Zealand white rabbits(4- 6 months old, both genders, weighing 2.0- 3.0kg) were used for the establishment of bilateral avascular necrosis of femoral head defect models and divided into 4 groups(n=6). BMSCs were isolated from the bone marrow of iliac crest, cultured and identified. L-PRP was prepared by Landesberg method.: core decompression only(Group A), core decompression followed by implantation of L-PRP(Group B), core decompression followed by implantation of cultured BMSCs(Group C), core decompression followed by implantation of cultured BMSCs and L-PRP(Group D) were performed in 4 groups. To evaluate bone formation and remodeling of the defects, X-ray photography was taken at 2,4 and 8 weeks postoperatively. The modified Lane- Sandhu scoring system was used to evaluate the bone formation. Two rabbits were sacrificed at 2, 4, 8 weeks after orperation to harvested the specimens for histological observation, new blood vessel count and newbone area ratio.Results The observations of radiology and histology displayed different degrees of the bone regeneration at bone defect sits in each group. At 2,4 and 8 weeks postoperatively, the results of Lane and Sandhu X-ray photography scoring, new blood vessel count and new bone area ratio showed the differences that groups C and D were significantly better than groups A and B, group D was significantly better than group C and group B was significant better than group A(P<0.05).Conclusion Our findings indicate that core decompression associated with BMSCs and L-PRP is capable of stimulating bone regeneration more effectively than isolated core decompression or in association with BMSCs or L-PRP alone in a preclinical femoral head osteonecrosis model in rabbits. These findings demonstrate that L-PRP can promote osteogenic differentiation of BMSCs in treating avascular necrosis of femoral head in rabbits, and core decompression associated with BMSCs and L-PRP is an effective and feasible method for treating early osteonecrosis.